From Clicks to Cash: Unlocking the True ROI of Your MedSpa Marketing

Erica Crawford

All right. So we'll go ahead and get started. So, some of you have been to my various webinars before, the ones Influx put on, but my favorite part of a webinar, I will always say this, is the Q&A and all the questions afterwards. So how it works is I'm going to introduce our guest in just a moment, but as he is talking, as we are discussing things, I want you to put your questions in the chat. Put it in the chat or put it in the Q&A, and at the end, we will answer all of your questions, make sure that you have everything that you need.

Some of you attended a webinar that I did with Audrey Neff, from Aviva a month or two ago. And we actually mentioned Illume because it is a rising company in the space and has a very, very interesting offering. Ben here is the CEO and founder of Illume, but I do want to tell you my two seconds on Illume, and I'm sure he's going to tell you a lot more about it. But the problem that we've had for ages, and the problem that you've probably had for ages, is that most of the systems that we have to track patients don't fully communicate to each other.

Like, you're going to have your EMR, and sometimes it's connected to your CRM, but sometimes it's only partially connected and doesn't pull in the patient data or what they're spending. And sometimes your QuickBooks is separate over here, and you'll have a separate chat and social, and there's not a lot of all-in systems that connect every aspect and every software that you're using for everything related to a patient. And Illume has come up with something that actually solves that problem, which is fascinating to me. So Ben is going to talk about that and a lot more about in general what happens once the lead comes in with the patient. So I'd like to introduce my friend Ben. Hi, Ben, you got the floor.

Ben Wolber

Yes. Thank you so much for having me, Erica. Again, it's been fun to collaborate in the space with the Influx team. I know we've done a podcast. I've seen you guys at conferences.

I know you guys are everywhere, similar to myself. But, yeah, again, how I like to start these things off is I can give a quick background on myself. So for those of you that don't know me, as Erica mentioned, I'm the founder and CEO of Illume. And in more recent news, which I can touch on this later, we actually just recently acquired a company in the space called Get Kudos. So if you're familiar with Izhak Musli, that was his company we just announced him today as our chief strategy officer.

So, growing quickly in the space. Most of our clients are med spas. We have some cosmetic dentists, and then we also work heavily with plastic surgeons as well. And again, like Erica mentioned, the original idea was to allow you all, as the end user, to plug in your different data sources, and then we have pre-built dashboard templates. Everything is fully customizable with our platform.

And again, we can work with any size of practice that we have groups that have 30-plus locations. We have groups that just have one location that have been open for six months. So, we can really plug in whenever you all really need it. But yeah, really excited for this conversation. And Sean, would you mind pulling up the slides, unless I'm missing them? Thank you.

So, again, I've been really excited about this conversation because it really does touch on one of the biggest disconnects that we've seen in just the medical aesthetics industry. So, from an Illume perspective, we have become really good at measuring marketing activity. So we can help practices sort of like say, "Hey, we know how many people clicked. We know what an impression can cost. We know what campaign drove a form fill and how much it can cost to generate that inquiry."

So, and what I think operators really want to know is much simpler. It's like, did any of that turn into money in our bank account? And maybe more importantly, did it turn into the kind of patient that is going to come back and continue to spend money with us? And again, I want to be clear up front before we dive into this is like clicks and leads do matter. They're the start of your patient journey, the story.

But a practice that has no awareness and no demand creation, is going to have a problem as they're wanting to grow, scale, whatever their goals are. And the challenge is that those numbers can become misleading when they are treated as the end result rather than the beginning of that patient journey.

So, on the Illume side, we spend a lot of time on what happens after marketing creates that interest. So does somebody book? Do they actually show up? What do they purchase? Did we collect the revenue? Do they return 90 days later?

If you only look at the first step, you can easily end up celebrating a campaign that generated a lot of activity without generating a lot of business. And again, the goal for this discussion today is to connect those dots, and I think it matters more in aesthetics because it's not just like a one-transaction business. Especially, like my wife works for a medical spa here in Cincinnati, so being a provider in this space and being connected to one, it's very much like a relationships-driven industry. And even on the vendor side, it's very much relationships driven.

And a patient might come back in for a consultation and then decide to do a treatment a few weeks later, come back for maintenance, retail purchase, come back, purchase a completely different service mix six months from now. But like that consultation, that first appointment is so important.

But the complete relationship is where you really understand the economics. And one of my favorite things on the provider side is like it seems like a really high-performing injector knows the patient's life story almost. It's like, "Hey, I know you have a wedding coming up. I know this is your goal in your personal life," or whatever their goals are. Really good injectors I've noticed are in the know with every patient that they're treating.

So, as we walk through this, I would really encourage everybody to think about the reporting you received today. If I asked you what you spent on marketing last month, you could probably answer that pretty quickly. If I asked how much you collected in revenue, those same marketing efforts, like from those marketing efforts, you probably, I assume most people would be able to answer that as well. But the gap is really what we're here to talk about.

So, and before we kind of dive in, again, feel free to put questions in the chat as we're going through this. I'm happy to take this wherever we see fit. But another way I like to think about this is like as an owner, you're not paying an agency because you want a better-looking dashboard. You're spending money to grow a healthy business.

And a healthy business doesn't just mean top-line revenue. It means acquiring patients economically, filling the schedule with the right services, making sure those patients actually arrive, and then creating a reason for them to come back in. The point is not to put marketing and operations in a separate bucket and ask which team is at fault. The point is actually the opposite, where marketing, front desk, providers, financial reporting are like disconnected, and then nobody gets a picture. When those functions work together, you can actually make better decisions within that same budget.

So, I can throw a question out to the audience. Question would be how many of you can see ad spend and leads in one place but have to open another system to see what those patients actually spent? Again, you can put the, you don't have to answer, but would love to hear as we kind of go through this. And then let's, as we go to the next slide, let's really follow one marketing dollar all the way through the practice. And Erica, if you have any thoughts. I know I just went through a lot.

Erica Crawford

Here's the thing is that from a marketing perspective, we're ultimately responsible for lead generation, right? But the truth is, is that that's kind of where it stops. We're not a software company. We might offer a CRM or something to help you, but it's not going to be something that we built or created.

Like for example, here at Influx, if you want to use GoHighLevel, we'll set that up for you. But otherwise, we're happy to work with whatever CRM or software that you utilize because at the end of the day, our job is lead generation and patient acquisition. Then after us comes software to make sure that you can manage all those leads and answer all those leads and see all your revenue, and that's the next step. So for us, it's really important that a client has really good software tools because you spend a lot of money on marketing. That's the truth.

Especially in the plastic surgery space, it can be expensive to acquire a patient. And you just want to make sure that none of that is lost. And obviously we have aggregate data across about 500 different practices, and it is fascinating to see the difference. We have clients who convert, I would say about 10% of their leads to bookings, and we have clients who are at the median, which the median for me, by the way, is about like 50% to 60% of all leads turn into a booked procedure. Not a booking, but a consultation, paid consult to be specific.

And then we have clients who do like 80%. So it's like this huge variation, and sometimes they're all doing the exact same strategy or like it has nothing to do with the lead quality. It just has to do with how those leads are handled. So it's really important to me that we have as much visibility as possible because that visibility also can help your marketing company a lot. Sometimes it is lead quality, in which case that feedback loop allows us to make sure that we pivot strategies as needed.

Ben Wolber

Yeah. I think you hit the nail on the head there. And really this visual, I know Erica and I were talking about this before we got on, but this visual you see here is deliberately simple. And so at the top, we've got ad spend, clicks, then leads and bookings, and then completed first visits, then collected revenue, and finally, returning patients. And every one of these transitions is a place where you as a business owner can lose that opportunity, and every one has a different operational fix.

Again, I've never ran a practice, so everything I'll say today even on this slide is from a data perspective. But really start at the top and you can run a strong campaign that earns attention and generates inquiries, but if the targeting is wrong, you may be attracting people who aren't ready or aren't a fit for your specific model. And then on the flip side, maybe the targeting is great, but the leads are qualified, but nobody's responding quickly enough. A marketing report can show a good cost per lead while the front desk could be letting revenue disappear.

So a hypothetical example here is imagine a practice spends, let's say $4,000 or $5,000 in a month and gets 100 leads. That's $50 per lead. And at first glance, that sounds promising, again, depending what your average treatment value is. But let's say only 40 of those leads book. So 20 of those people show up and only 15 become paying patients.

You didn't acquire 100 patients, you acquired 15. So if you measure the cost based on those 15, you spent roughly $333 in ad spend for each new or paying new patient. So this is where you can start asking whether that works economically for your specific practice. But again, I don't want us to stop there either.

What if those 15 patients each spend $800 over their first year? That looks very different from a group that spends $1,500 or $2,000 or $3,000. And if the practice has a strong repeat visit strategy, a first transaction might not be a very good indicator of lifetime value. Which is why at the very bottom of this funnel, you can see returning patients is not an afterthought.

The first transition is clicks to leads, and that can tell you something about creatives, landing pages, calls to action, audience, like how you're drawing that patient into your practice. The second bucket is that leads to booking. So this is where call handling, response speed, availability, financing questions, and the scheduling experience can really matter. I would never automatically blame any marketing agency for a low lead to booking rate without looking at what the practice is doing when the lead comes in.

Something I've learned to appreciate, I mean, even in the day of AI, is when you talk, like in any business, when you call the business and you get someone human on the phone. There's a ton of power in that because again, I ran into this today. I'm planning to leave, I'm going out of the country on Friday. I called my bank, and it's an AI-generated prompt. It takes me 10 minutes just to get to an actual person like, "Hey, just letting you guys know I'm going to be out of the country. Didn't know how to tell you guys this without waiting on hold for 10 minutes."

And it's little things like that where in a practice setting, it's like when a lead comes in, whatever your practice's goal is, if it's possible, try to have someone pick up the phone call within 30 seconds. If you just have someone immediately call, "Hey, Erica saw your website and inquiry. How can I help you?" I think there's still a lot of power in that human touch.

And then as we work down, we have booked to completed. So this one is definitely underrated in my opinion. So someone booking an appointment is not the same thing as coming in. So how often are people canceling? How many no-shows?

Is there a long wait between inquiry and appointment? Do reminders help? Is the provider's schedule convenient? So if one campaign is generating a bunch of bookings but hardly any completed visits, you have to investigate that area before you celebrate.

And then the next bucket is that completed visits to revenue. So some first visits lead to a consult but no treatment, and some convert into packages or memberships, whatever that conversion process is. And then also some lead to follow-up recommendations. That's where the provider experience creating a specific treatment plan for the patient, pricing, service mix, and patient really fit all. This is where they all enter the picture. And it's entirely possible for two campaigns to drive the exact same number of new patients, but drastically different financial outcomes.

So one important distinction is revenue is not one universal number, especially in cash pay healthcare. Sold revenue and cash collections can be different. So think like packages, prepaid services, gift cards, memberships, and financing arrangements create real reporting nuances. So you as a practice, we have to decide what we're measuring and what your North Star metric is, and then keep that definition consistent and then avoid accidentally double-counting money when a prepaid service is redeemed.

So another example is campaign A delivers 30 new patients at $200 of ad spend, while campaign B delivers 20 new patients at $300 each. So campaign A wins on an acquisition cost basis. But if campaign B brings in a high-value patient segment that returns consistently and contributes substantially more margin over time, B might be a better investment. Again, I would argue that from a data perspective. And the goal isn't always the cheapest patient, obviously, it's the right patient at a sustainable acquisition cost.

And obviously a caution on attribution. We can get much better at tying marketing sources to actual outcomes, but attribution will never be perfect. So someone may see a social ad, search your brand later, call from Google, and hear about you from a friend. That doesn't mean measurement isn't worth doing. It just means we as an industry should use consistent methodology, acknowledging uncertainty, and look at patterns instead of treating a single source label as absolute truth.

And really when a practice tells me we need more leads, my first response is usually, "Maybe, but let's look at what you're doing with the leads you already have." If your booking rate is 20%, moving that rate by 30% can be a much bigger and faster win than spending more money to create the same leakage. And the best growth strategy may be fixing the middle of the funnel before scaling the top. And Erica, I'll pose a question to you. Where do you see the biggest disconnect between a campaign looking good and then a client actually feeling growth?

Erica Crawford

Generally there's not that feedback loop. I will reiterate, it's important to know. One thing about Google Ads, which not everybody sometimes may not understand, but let's talk Google Ads specifically here. Google Ads needs the feedback loop in order to optimize better, meaning you actually, it's not just for the agency or the person who's running your ads, but the actual Google Ads platform.

If you could feed back into it like, "Hey, these other leads actually converted," the ad will then perform better and then continue to target the right people. So it's really important to have that feedback loop continuing, not just for the sake of your agency, but for the ads themselves. And I will say a couple of numbers, kind of just getting to your point, Ben. I mentioned this a little bit earlier, but I'm just going to reiterate these numbers because I think they're really important.

These are rough numbers. It really depends a little bit on where you're physically located, how much competition you have, a lot of different factors. I will give you numbers for somebody who's in what I call a mid-market. It's a competitive market. There's other plastic surgeons around or practices around, but you're not in a small city, but it's maybe not Miami. Okay?

So mid-market, right? What we like to see is that we would like you to schedule at least 55% of your leads into booked consults. Now, when I say 55% of your leads, I'm going to clarify exactly what I mean. Those are from Google Ads or from organic search. That can come from AI or Google Search or even word of mouth, whatever, coming through your website.

Basically, I'm not including social media in this bucket, just to put it really simple. So outside of social media leads, we are talking about just organic from Google or paid Google leads. Our best practice is book at least 55% of those into paid consults, meaning that they'll spend $300 or whatever to book a consult. Then once the person comes into the consult, I expect 70% of those to be turned into booked procedures. So by that math, that is roughly about 38% of all your leads that come from either organic search or paid Google Ads should book into a surgery.

Now, that's a rolling date, meaning you might have somebody, a lead that came in from July, book a surgery here in October. So it's not like the same math, like that month leads to that month. That doesn't matter at all. I'm just talking about your end numbers, like what the overall numbers are at the end of the month, even if they don't perfectly match to that exact same patient number. Does that make sense?

So that number you're keeping consistent. But if I'm not seeing those numbers or somewhat similar numbers, I feel like something is off in terms of it could be lead quality or it could be lead handling. Those are really the only two things, right? And maybe it's both. So maybe the marketing agency needs to figure out and take responsibility on how to improve the lead quality.

Or sometimes you find there's something wrong with the lead handling. It has to be one of those things are off if you're not somewhere near those numbers. Social media numbers are way, way less, both for organic and paid social. It's fine that they're less. They're still very valuable. They're cheaper to get. So there's an expectation of that. That's why I like to separate out those percentages and exactly what buckets and what type of advertising and what type of patient acquisition I'm talking about.

And also similar to what Ben says, the data is the data. You kind of got to go like, "Hey, look, if a lead comes in through a paid ad or a lead comes in through organic Google, let it be whatever software CRM says it is." So I will say, I sometimes find people, they talk to the patient, and they go like and change where that lead source is. Like, "Oh, well, the lead source really found out from a friend." And I can't help but go like, "But they were searching breast aug near me."

I'm not saying that they haven't heard about you from a friend. I'm just saying, that's not what they were searching when they landed on you. So they might communicate something to you that could be true, but it's not just like the total truth. The whole truth might be like, "Yeah, I was looking at a lot of different practices, and I was evaluating it, and one of my friends says you guys are decent." That might be the actual truth.

So do make sure that whatever data set you're doing, you just keep the attribution consistent and don't change that around because that can be very messy to analyze later on.

Ben Wolber

Yeah. And you bring up another question. When you mention the word quality, this question came to me. So, Erica, I have another question.

Erica Crawford

Yeah, absolutely.

Ben Wolber

So what role does offer quality, would you say, play in lead quality versus just generating volume?

Erica Crawford

Yeah. We typically do a lot of things to... Obviously, organic is organic. I don't really want to hear about lead quality when it comes to organic, just to be blunt, because they're just people searching, right? There's no way to control that other than getting you ranking for the procedures that you want the most of. But they are coming in organically through AI search, more from SEO, and that quality is actually quite high.

So now if we're talking about Google Ads specifically, that's kind of what I mean. You can control quality a little bit more in ads. Typically speaking, we do this at Influx. Not every company does, not every person does, but we do a lot of negative keywords. So, we filter out things like price shoppers or people who use words like insurance.

We also, by default, unless it happens to be a competitor who's got a hit out on you, and they're doing a targeted campaign on you, which doesn't happen often, but it does happen sometimes. We also don't do brand searches, meaning if somebody's looking for Dr. Ben, we're not showing the ad to them. Why would we need to show your ad to Dr. Ben? They already know who you are. They're searching for you.

So these are the things that I mean improve quality. So I don't want your tummy tuck ad showing to cheap tummy tuck near me. You know what I mean? I don't want that happening. And that's the best way, honestly, to filter out and improve lead quality.

Negative keywords is a consistent thing. It's not like you can just do it once on paid ads without getting too technical on that. It is a consistent thing. So that feedback loop might need to be there, and the ad team will have to adjust it on a monthly basis or tweak this here or try that here. It's not like, why didn't you do it in the beginning? No, it's an ongoing process.

Similar with targeting certain zip codes or, just there's certain things that you just kind of learn. Also, what's the sweet spot? Is it 30 miles radius? Is it 40 mile radius? Is it 100 mile radius? There's certain things that you will only know from trial and error. So those are the things that improve lead quality. You have to go down that rabbit hole, but you'll have to have a feedback loop. Otherwise, how are you going to know?

Ben Wolber

Yeah. No, I do think, last thing I'll say on this topic, and then we can transition to the scoreboard that I would actually use, but that feedback loop is so important. How are you collecting those Google reviews? How are you ensuring the patient feels heard? And again, it's like if you get a negative review, that's fine. We're all human. You're not going to be perfect.

But what's your feedback loop after that? It's like, "Hey, Erica, I leave your MedSpa a terrible review. I had the worst time. One star." Erica, the second I leave that review, your front desk, even you, if you're the provider, you should pick up the phone and call me like, "Ben, what happened? What could we have done better?"

So having that feedback loop be automated is where we've seen a lot of... Because we work with a lot of practices at different sizes, some of the most successful practices we work with, from a revenue perspective, I would say, their processes for Google reviews feedback are very well oiled, where if there's a one-star review, it's like someone, most of the time it's the owner actually, someone's calling them within the hour at least. So, yeah. And again, we can switch gears now to the KPIs that tell that real story.

Erica Crawford

For sure.

Ben Wolber

So, here, obviously, being the founder of Illume, we're going to talk numbers, but these are five KPIs, but they aren't five independent report cards. So they all kind of work together. Again, from a marketing perspective, I don't recommend trying to measure every single area of the marketing spend. I always recommend even taking marketing out of it, focusing on one area of the business that you're feeling the pain the most in.

But my cost per lead, lead to booking rate, booking to completed visit rate, customer acquisition cost, and patient lifetime value. If you pull one number out of context, you can tell yourself a very misleading story. So I do think, again, all of these are kind of interconnected.

So cost per lead is the simplest starting point, I would say. So it's spend divided by your leads. So if I spend $5,000, I get 100 inquiries. My cost per lead is $50. That's great to know.

But leads are not a standardized product. So one lead may be someone asking for a pricing on a service you offer. Another may be somebody ready to book a high-value consult. Treating them as equally valuable can distort the decisions downstream.

So then the lead to booking rate tells how much demand is turning into a scheduled opportunity. Like 100 leads and 40 bookings is 40%. So now we can compare by source, location, service line, even time period. So if it's low, my next step is not necessarily to rewrite the entire ad. I'm going to look at lead response time, missed calls, text workflows, available appointments, and how the team is handling the conversation.

And then booking to completed visit rate tells me where the scheduled opportunity actually became a patient interaction. So 40 bookings and 20 completed first visits is 50%. That's a serious operational question. Is it a no-show problem? Is there a long wait time? Did we count rescheduled appointments as canceled? We need clean definitions, or we could really diagnose the wrong issue.

So, and then now switching a little bit to customer acquisition costs. Here is where for this conversation, let's define CAC as paid ad spend divided by new patients who completed a first visit. So 5,000 in paid spend divided by 20 completed new patient visits means $250 paid media CAC. So if the business wants a fully loaded CAC, we can include agency fees, we can include content production, we can include software and sales labor, but then the numerator is different.

However, both can be useful, but the mistake is comparing them as if they're interchangeable. So again, it goes back to defining your specific practice's business logic. And then another subtle distinction is if you're using first completed visits as your denominator, not necessarily all 20 visits are attributable to those specific ads. So a clean paid media CAC requires matching the attributed patient cohort to the spend as consistently as possible. Again, probably not going to be perfect 100% of the time, but for practical reporting, document which method you use and don't silently switch definitions month to month.

And then the last one is patient LTV or lifetime value. And this is the reason I think aesthetics is such an interesting business because a patient who has a $300 first visit may go on to have thousands of dollars in cumulative spend. Or they may never return. Again, I heard a stat at one of the conferences I was at, and it's like 50% of patients don't come back, which means like if me and Erica launch a practice, I'm not going back, or Erica's not coming back, which I think that stat is crazy.

So, really a true lifetime value calculation uses a defined time horizon and a cohort and should distinguish revenue from the contribution margin when you're making a profitability decision. So the point here is to avoid using an exciting revenue number as proof that every advertising dollar is profitable.

So from here, let's put these numbers together in one hypothetical practice. So $5,000 spend, 100 leads, 40 bookings, 20 completed first visits. Our cost per click is $50. Lead to booking is 40%. Booking to completed is 50%, and the paid spend per completed visit is $250.

So if those patients average $900 of collected revenue in their first year, that gives $18,000 in first-year collections from that 20-patient cohort. That's useful context, but from my perspective, we would still need treatment costs, timing, attribution confidence, operating overhead, before calling it profit or ROI. So again, hypothetical situation. Imagine next month we improved booking to completed from 50 to 75%. So 40 bookings produce 30 completed visits instead of 20.

With the same 5,000 in paid spend per completed visit drops from $250 to about $167. Don't quote me on that. We didn't need a bigger ad budget, but we needed to retain more of the opportunities we were already paying to acquire. So again, that's why these metrics become actionable when you look at them all together.

And my favorite question to ask is not just what happened to CAC or like it's why did the CAC move? Did cost per lead increase? Did the team convert fewer leads into appointments? Did no-shows rise? Did we shift toward a service that has a longer consideration cycle? Those are different problems with different solutions, and a single number won't tell you which one you're facing.

And then another important piece in this segmentation is a blended number across 10 locations can hide an enormous amount. One location might have an excellent demand but a broken booking process. Another might book beautifully but struggle with consult conversion, like plastic surgery, injectables, hormones, and wellness services can have different sales cycles as well and repeat that. So you have to compare who's performing well.

And this is also how I think about holding marketing and operations accountable in a fair way. So marketing can own audience messaging and creatives and the quality of opportunities generated. But then the practice owns or shares responsibility for lead handling, availability, patient experience, and clinical conversion. And both sides should care about the final financial outcome, and the data should bring everybody to the same table rather than give them a new way to blame each other. But, Erica, from your Influx perspective, do you see clients asking for a target cost per click when they haven't defined what a quality booked patient is worth?

Erica Crawford

Yeah, I mean, that can happen a little bit on a cost per click. I feel like there have been times when we'll just hear like, "Okay, none of them is booking, none of them scheduling," and we don't hear why. And that part is really important to us in order to make the ads perform better. Yeah. Specifically, people expect a five-minute response time, even on nights and the weekends.

That is what is expected, and that is what all our most successful practices have, I would say, like some sort of leads handling from 8:00 a.m. to let's say 9:00 or 10:00 p.m. every day. I'm not saying they have to answer a lead at 2:00 in the morning, but they have it somehow staffed or worked out or somebody to answer leads during those times. And then they'll even incorporate AI agents and stuff to help with those off times. But they actually have the resources to fully handle all the leads all the time. So that's a huge part of it, is time to lead. That can ruin you right away.

Because somebody typically, we already know, and there was a survey, I think ASPS actually put one out recently, where it says that more patients are willing to spend, and basically they're going to always choose between three or four plastic surgeons at the end of the day. So being quick to respond, how you respond, especially for a big procedure like a mommy makeover or facelift, that means that they also will pay three booking fees, right? Or three consultation fees. They might spend $900 just to see three different plastic surgeons. So these things kind of matter with the competition, having the feedback loop of why.

But when we do find a practice who doesn't really have the sales team in place, it's hard to reconcile that a little bit because you go like, "We already know based off of the numbers." And sometimes it's like the opposite where we want to have a client that wants to spend more money and we're like, "That's not the best idea right now." I have a client who gets a few hundred leads a month. He's a big practice. It's busy. It's a couple hundred.

And he was wondering around doing paid ads, and I was a little confused because for that amount of leads for a single plastic surgeon, that should really do non-surgical, mostly just surgery. I was like, "That should keep you pretty fed," right? That's a decent amount for one person. So I asked, "What are your percentages?" And his booking rate, consult to booking rate, so we're not even talking lead to consult, but the person that's physically arrived into the practice and paid for a consultation fee was 30%. And I was like, "That's a huge problem. That's a huge problem."

Something is, are you even seeing them on a patient care coordination as well? I'm like, "Okay." But you know what I mean? You've got to see them as a plastic surgeon as well. I mean, there's different ways to set that up, but I just went like, "I promise you, this is what you need to fix first."

And typically speaking, we do advise what we see as best. But we also advise, we have so much data from so many practices that we don't advise in a vacuum either. You know what I mean? We're advising based off of what we see. The only thing that's not perfect, that I will argue will never be perfect is meta leads, right? Paid social leads.

And I'll tell you why. There's a lot of legal considerations about meta pixels. Personally, at Influx, we do not use them. So it's really hard to track a patient that has come from a paid social media ad campaign. It just is. We don't know what happens the second they leave Instagram.

So let's say somebody goes and sees you on Instagram and they're like, "Ooh, this person looks interesting, so let me go Google them, and let me go look at them, and let me go pull up an AI search." We can't see them anymore. That tracking is gone for us. Whereas with Google, sometimes we have a way to keep tracking them, unless you're in California. Sorry, California. But that's more of a new thing and a whole nother conversation.

But that is also something that is interesting, where some, I will say with meta is the only thing that doesn't, everything we're talking about is not going to fully apply because you just, you don't have that first step. You have to go a little bit by, I hate to say by feel, but like, you're running meta ads. Are you getting more patients from when you weren't running them to now you are running them? It's the only area that we can't perfectly calculate the same way.

And then the only other thing is that places with really strict legislation, which right now is California, and potentially Florida will be next. The only thing that California and Florida have ever agreed on, I guess, is about not tracking anything about patients ever. But no, these are state laws. They're not actually HIPAA laws. It's a whole nother conversation.

But we, for example, have cookie consent banners on all of our California websites. Right? Like just automatically. Whereas for other states, we let the clients choose if they want to have it or not, because the laws are not quite as strict as California. But that instantly, we're no longer aware of 50% of people opt-out, just so you have a number. Roughly.

So it's an interesting thing. So it's like you want to get as much data and calculate as much as possible. And when you do have the data, it's important to use Illume and important to use every piece of software you have to calculate it as best as possible. But there's always going to be a certain percentage that, unfortunately, because it is, at the end of the day, medical information, we will not be able to fully see. And there is a little bit of it where you go, "Okay, is my practice busier?"

Ben Wolber

Yeah. No, I mean, you bring up so many interesting points. Some of them I'm not smart enough to speak on. But I've definitely seen it with the practices we work with. And it is a great segue into our next portion, is like how do you turn these insights into the action? And again, this is where I think the conversation gets really interesting.

And if you don't mind switching the slides. But again, this is where again, selfless plug here. This is where Illume can be helpful. So like dashboards are helpful. Obviously, when we first entered the space, we were reporting an analytics software. But if you finish looking at a dashboard and you still don't know what to do Monday morning, it isn't doing enough for that operator.

And so the opportunity here is what you were saying, Erica, is to take the data, identify specific behavior, or a lever, or recommended decision that you can actually test. So again, on the left is an example around consultation pricing and appointment allocation. The system is identifying a possible inconsistency in what time is worth across different appointment types. That doesn't mean I would tell a practice to raise prices blindly. I would want to understand consult duration, conversion to procedures, provider mix, patient satisfaction, and longer-term downstream revenue from these consultations.

So imagine a provider whose calendar is packed, but a significant percentage of those appointments are low yield, long duration consults. So the issue might not be a lack of demand, it could be how the schedule is structured. So could some questions be answered before the visit? Maybe. Should the consult be positioned differently? Would better qualification, would a better qualification of that lead be more productive and lead to a more productive appointment time?

Those are operational hypotheses that are worth testing, not automatic answers. And again, that's where I think AI can be just in general, can be extremely helpful, is identifying patterns in your data. So whatever tool you're using, it's like when you're using it on your data, it's so helpful. Be like, "Hey, here's the pattern we are seeing based on the data." Again, you're the expert in your business.

You're, like Erica, as the marketing expert, take this information, act on it. And again, you might not use it word for word, but again, that's the fun part about having AI-driven insights is you're the expert. You take that, it might give you some guardrails, it might lead you into a direction that you might not have landed on organically.

And then here on the right is just another example, is a breakdown of geographic service delivery. So you may see clusters of patients traveling long distances for a specific service. That's a very different way to think about expansion. So instead of saying, "Hey, we think that neighborhood looks attractive," you can start by asking, where are patients already coming from? What are they buying? How frequently are they coming back? And is there enough concentrated demand to test targeted marketing, pop-up days, teleconsults, where appropriate? Or ultimately, do we open another location?

And I want to be clear here, an estimated opportunity card is not cash in the bank. These numbers and using AI, they're models or hypotheses. I still argue, and again, I'm an AI native company, but the operator still has to validate feasibility, clinical requirement, costs, market context, and they're the expert in the business. But now we're having a much more specific conversation rather than, "Hey, Erica, sales are down. Should we run another promotion?" I have no clue.

You can bring that exact same thinking back to marketing. So suppose one campaign attracts patients who purchase a one-time service. Another attracts people who consistently return for maintenance. You can build different follow-up programs, testing messaging, and measure whether repeat visits improve. Or suppose you're seeing many booked consults, but fewer treatment starts. Rather than buying more leads, you can focus on the handoff between marketing, front desk, and the provider.

And then another example, and this is probably my favorite part of working with practices, is patient reactivation. So almost every established practice has patients who should have returned for an appropriate follow-up but have not. And so if you can identify relevant segments from actual treatment and visit history, you can build targeted outreach rather than sending the same offer to every patient. Now, of course, the clinical appropriateness, permissions, privacy requirements matter, but the general overall idea is the same. Where it's like you use the information you already have to make the outreach relevant. Again, something I've heard from being on the conference circuit the last year is your warmest leads are sitting in your EMR.

So it's like pull those lists together. It's like, "Hey, I need a list of 50 patients who have spent $10,000. Their last service was a toxin they haven't been in in 180 days." That's a great working list for a patient coordinator, front end. Whoever's making the calls, that is a great check for someone to focus on for a day.

Because again, out of those, you could convert 20, you could convert 40, you could convert five. There's still money to be made there. It doesn't cost you really anything aside from maybe some time. And again, from the Illume side, the patient reactivation portion of a practice is what we're most excited about, is connecting those dots throughout the practice so that the owner does not have to export six reports to answer one question.

But regardless of the tools you use, I would encourage to figure out an operating rhythm where you pick one metric that matters, assign the owner, choose an intervention, and measure again in 30 days. Because better decisions and a repeatable cadence beat an impressive dashboard 10 out of 10 times. So my broader message here or theme here is there are really two growth levers. You can generate more demand, and you can capture more value from the demand you already use.

But strong practices do both, and if marketing and operations sit in separate worlds, each team only sees part of the opportunity. If they shared a complete picture, then they can prioritize where to intervene and then actually focus on what is going to collect more revenue and then also build stronger patient relationships.

So, I have a question again. When data shows the problem isn't more website traffic, more traffic just in general, Erica, how do you change that conversation with a client? I'd be curious to know.

Erica Crawford

Yeah. Honestly, I will say this is something we haven't touched upon as much, but I can sort of see from some of your recommendations that Illume has, like optimizing your geographic service delivery or things like that. I will say that one thing that nobody likes to hear and we don't like to say is when competition is affecting a market. Sometimes you'll have a new practice open up and they will decide to put 40 grand a month onto a breast aug campaign. And then suddenly your breast aug campaign that was performing so well suddenly costs a bit more, and your cost per click is higher.

And I will say that's an inevitability sometimes. It is a bidding system. That is how it works. Right? Competition does matter.

There's some studies coming out and because we still have a whole quarter left, I don't want to say anything too definitively. But right now we kind of have an idea that plastic surgery is up this year. Plastic surgery overall, interest into plastic surgery will probably be up about 7 to 12% 2026 over 2025. We don't know that for sure. It's up.

Is it as up as I would like it to be compared to the number of new practices that have opened as well? Maybe not. Maybe just slightly up, if you think about that because you do have the factor of increased competition. But overall, it's up. I think that is a win. Our industry is succeeding again, even when other industries don't.

But what looks like, and we will see where this lands, and I'm sure this will be broken down and we'll get something from Q Site and all sorts of things in the new quarter and AMSPA and different conferences and things like that. But it looks like nonsurgical is going to be somewhat stagnant this year, for example. Which is interesting because a lot of new med spas have opened up this year. Like a lot.

So when the interest is kind of stagnant, but there's a lot more competition, you just have to be willing to adjust your strategy. And hopefully this is kind of a roundabout way of answering your question, Ben. You have to be willing to adjust what you're doing, factoring in that competition. And of course, I'm sure we will get a breakdown. Like I said, we'll get more data. Typically, we don't actually get all the reports until the end of Q1, but that's what it looks like right now.

I did see a mid-year report that kind of pointed that direction for nonsurgical, and it probably will break down. It'll be like, "Well, injectables are up because they're always up and lasers are down," or whatever. It's going to be broken up. But it's been a while since nonsurgical has been down, to be honest. And considering the number of new med spas, it's just something to factor in.

So if historically, you hit a certain, you always spent X amount of dollars and got X amount of results, you kind of have to shift year from year. That might need to change a little bit. And that is one thing. I will say that's one of the hardest conversations we have because we want to be responsible for your patient acquisition and be responsible for getting you quality leads, and we are responsible for that. But there's also an aspect of if you've done the same thing all the time, year after year after year, and you're unwilling to pivot one way or the other when the landscape has changed, you're just going to fall behind. That's all.

I know we only have a couple minutes left, so I would love to hear any questions, whether it's about measuring a specific service line, lead conversion, attribution, or connecting marketing to patient data. I would love to hear if anyone has any questions. I know we only have a few minutes left.

Yeah, I have some questions. We have some questions to bring up. Let's see. First off, when a practice first connects their data to Illume, what is usually the biggest surprise? What is something that they don't expect out of it?

Ben Wolber

Again, selfless plug. I guess, Illume. So, I think it's our pre-built reports, transparently. Even from just having the power of all of your data in one place is frightening on one hand, but then our most popular feature is the chatbot in our platform.

Erica Crawford

Okay.

Ben Wolber

People are just coming in there and just asking questions. And then what we do really well is we have a very provider-focused approach. So when we work with a practice, no matter the size, we will deploy versions of our tool all the way down to the front desk. So everyone gets a specific gated login, and then they're all working towards whether it's a provider that's on a commission structure, they have four metrics usually that they're being compensated with. They can log in, ask questions about their performance, set goals around it.

And then also if you don't do profit sharing or commission structure, you have your North Star metrics and it's like, "Hey, we have a total sales goal this month." Everyone should have something because each role in a practice can play a significant part in helping the practice hit that goal.

Erica Crawford

Yeah, that makes sense. Okay, good. I'm going to keep rapid-firing questions, okay? So next one is what are you seeing in practices that ask the chatbot the most?

Ben Wolber

It is fun. We can see everything that people are asking, but we've seen some arguments with the chatbot sometimes, which is funny because I've fallen victim to that when arguing with ChatGPT or Claude or something. But honestly, the biggest signal for me was, again, going back to our thesis to the market is that we want to work with the providers. Yes, owners, operators are super important, but we want to work with people that are on the front lines doing the service. So I pulled a question probably a month ago, and it was from one of our providers, and she was essentially asking how can she improve her retail attach rate.

But the way she asked it, I thought was interesting when she said, "Hey, I'm booked. I'm working these two days next week. I'm keeping with my currently booked appointments. Is there an upsell opportunity? I have no clue. Can you just tell me based on the patient history, treatment history, or historically what treatment services have paired well with retail products?" And again, one of her metrics for commission was that retail attach rate.

So again, I thought that was so powerful. And that was probably one of the favorite questions I've seen. Again, not really related to marketing, but it was really around performance improvement. And I think that's, again, the power of just AI in general is using it to improve your performance, your company's performance. Again, it just helps analyze trends, and then again, you still need that human touch.

But Ava's our chatbot, and she gave her three or four recommendations right there, saying, "Hey, you're booked. Here's the booked appointments. Here's where there's opportunity based on the data." Again, don't force that sale into the conversation, but if it comes up organically, use your sales training that you've all been trained on. So, that was probably the most interesting question I've seen.

Erica Crawford

Yeah. I will say that this is why we do a plug for this. Aesthetics is such a unique space, right? The probably only place that we overlap a little bit is maybe with cosmetic dentists, just because it's a similar patient. The person who's getting all on fours or full veneers or implants or they're spending, those could be 15 to 50 grand procedures, right?

But with that said, in aesthetics, I will say it's why it's really important to work with a company that specializes in this space and does nothing else, because that aggregate data that you have across all of your practices, my gosh, it would help with your AI chat, but also here at Influx, it informs everything because we don't really do anything else. We don't do any other industry. So for us, having all the aggregate data across all our practices really helps. And of course, obviously with things like we're doing something proprietary, very specific to just one practice that stays that way, and it's covering our contracts.

But there are just some general rule of thumbs that you learn and it can help, I'm sure with your AI and just in general with marketing, it's an interesting thing. Which brings my next question, and I'll answer it too, but what is one metric that you see practice owners obsess over that's not that important to you? That's less important than they think.

Ben Wolber

I would say it's kind of like a buzzword at conferences. I've talked about it for 20 minutes here. And so I've fallen victim to it. It's like LTV to CAC. I feel like I hear that in any presentation.

Again, I did not know what that was until I came to this industry, transparently. Historically, I worked in these large hospitals, and then I worked in FP&A and corporate development. So, I was very a finance background. So coming in, we learned about LTV to CAC. I still think it's important. But I do think that's something that people get hung up on quite a bit.

And again, going back to the slide that we had, it's like understanding each of those levers, that's where you get the whole picture where, yes, LTV to CAC is great, you should obviously care about that. But I think that's where a lot of practices get hung up on, focus a little too much on their, not forgetting cost per lead, lead to booking rate, booking to completed rate. They're all part of an equation that you should be looking at from a marketing perspective.

Erica Crawford

For sure. For me, it's going to be, I'm going to give this a kind of like, I'm going to say it, but I'm going to say it with a caveat. My own team members might disagree with me, some of my own team members will, I'm just going to tell you that right now. I feel like Google Analytics is a little bit meh sometimes. It can sometimes give really good information and like, okay, you got bounce rate and visitors and all sorts of things.

But at the end of the day, Google Analytics doesn't really tell you where are you ranking? Are you showing up in AI? How many leads are you getting? Those are the things that are really important. And sometimes you can do really well with your visitors or Google Analytics not doing well. Or vice versa, you could be doing really poorly with your Google Analytics doing really well. So it can sometimes have misinformation.

The reasoning for that is that blogging is typically an important part of SEO strategy and AEO, AI search. The interesting thing about blogs, though, is that the benefit of blogs is that it will help your SEO and AEO, so you're going to get more visibility. The downsides of blogs is sometimes it will show, not sometimes, often, you're going to get a lot of international searches, meaning people who will never be your patient. Maybe a couple of them might fly in, but some of them, the conversion rate on it is much lower.

So sometimes that can drive a bunch of traffic to your site, and it's a good thing. I'm not saying it's a bad thing. I'm just saying it can be misrepresented sometimes, where a blog can basically go viral on the internet for six months and then show a bunch of just traffic of people who will never be your patient. And then that blog will go, that traffic will actually disappear because it's not always consistent with blogging.

And then it, it just basically misrep-- Google Analytics can just be up and down sometimes in a way that doesn't have anything to do with your patient acquisition at the end of the day. So I'm not saying I don't like it, I'm just saying it's just not as important as some people make it. At the end of the day, your leads are what's the most important more than anything.

And I will say that with certain, we're not doing whole legal talk, but with, I think tracking is going to be harder and harder as things, like with Google Analytics, like I said, we, for example, we work with California clients. We only get to see half of Google Analytics because everybody opts out of tracking. And I think that's going to be, I don't think that's going to go away. I think that's going to be more strict in the US, because in Europe, for example, that's been an absolute no-no for a very long time of any form of tracking on that whole website. So it's, we're actually a lot looser about it.

Okay, another question. Oh, here, go ahead.

Ben Wolber

Yeah, I saw a question come into the chat, and it was, "For a small front office team, have you seen better conversion from an AI scheduler or a live after-hours answering service?" To me, and I'll give you kind of a long-winded answer here. For a small front office team, I would lean towards an AI, again, not knowing anything about your specific practice. I would lean towards an AI scheduler for the initial lead response and after-hours booking, assuming it's integrated properly with the practice's scheduling system.

So the biggest advantage is speed and consistency. And an AI scheduler can respond immediately and handle multiple inquiries simultaneously, and potentially book patients without requiring additional staff. So, like that said, I wouldn't say AI can universally convert better than a live answering service. Like a trained human may perform better with high-ticket consultation, complex treatment questions, or patients who need more reassurance before booking.

But my ideal state, honestly, because again, I really like having a human element in all these things, is somehow figure out a hybrid model if possible. So AI can handle initial inquiries, routine scheduling, after-hour follow-up, while more complicated conversations get escalated to a person. So, and again, I would evaluate success based on the actual outcomes, not just the calls answered or appointments booked. So some example metrics, not to information overload is lead to booking, booking to completed, cost per completed, and then revenue collected per lead. And then also track the cancellations or no-shows from those AI scheduled appointments.

So, really to me it isn't necessarily whether AI or a live person answers the phone better. It's just which solution actually gets more patients through the door. And again, an AI scheduler books 100 appointments, but only 40 show up. And a live service books 70 with 60 showing up, a live service may actually be delivering more value.

Erica Crawford

Yeah, I agree. I'm not a huge fan in general of outsourced answering services or lead-handling services in general. But that's just my, I was basically going to say the same thing a little bit more just like, I'd rather you use your own staff and then use AI to help you. But people need to have skin in the game as well. And a random person just answering the phone that's not actually your own staff. Funnily enough, I feel like the AI has more skin in the game than that in a sense.

Funny to say. Okay, otherwise, we're kind of running out of time. Is there any other questions for us? And of course, there's the information, so you're free to reach out and ask more questions as you have them. But Ben, thank you so much for joining us today. This has been really helpful, and thank you for everybody for coming, and I hope you have a great rest of your Thursday.

Ben Wolber

Yeah. Thank you all. Thank you for having me.

Erica Crawford

Thank you.